Mohs Micrographic Surgery in Female Genital Cancers: A Systematic Review

Mohs micrographic surgery (MMS) has shown promising efficacy in female genital cancers, including Extramammary Paget’s disease (EMPD), dermatofibrosarcoma protuberans (DFSP), squamous cell carcinoma (SCC), and basal cell carcinoma (BCC). However, limited consolidated research exists on the clinical outcomes following MMS in female genital cancers. The aim of this systematic review is to synthesize and evaluate recent literature on the application and utility of MMS in the management of female genital cancers.

A comprehensive search was conducted of the PubMed and EMBASE databases on October 16, 2024, using the keywords "Mohs surgery" or "Mohs micrographic surgery" and "female genital" or "vulvar cancer" or "vaginal cancer" or "genital cancer" or "vulva" or "vagina." Studies were included if they directly discussed MMS for female genital cancers, particularly EMPD, DFSP, SCC, and BCC, with attention to clinical outcomes, were of the correct study type, and were published in peer-reviewed journals in English.

Our results identified a 95% curative rate following MMS for EMPD, DFSP, SCC, and BCC, following analysis of 166 treated cases.

MMS provides superior outcomes as compared to traditional excisional approaches, potentially secondary to its precision-guided approach and histological analysis. Future studies should utilize larger patient cohorts and investigate rarer malignancies and combination therapies to optimize treatment guidelines for female genital cancers.